Strangulation in sexual homicide: Is it opportunity,victim's vulnerability or sadism?

Although most homicides involve the use of a weapon, some offenders still prefer killing with their own hands, using strangulation. In fact, when disaggregating the various types of homicides, sexual homicide offenders appear as having a preference for “personal weapon” to kill the victim. Personal weapons, such as strangulation, asphyxiation, and beating, are the most commonly used killing methods in sexual homicide. Using a sample of 451 cases of sexual homicide of adult female, the current study examines three hypotheses as to why strangulation is the method of choice to kill in sexual homicide: 1) weapon of opportunity, 2) victim's vulnerability, and 3) sexual sadism. Results from logistic regressions and artificial neural network analysis show that all three hypotheses are supported, sexual homicide offenders using strangulation being less likely to target a victim with a strong build, to bring and use a weapon. However, strangulation is more likely to be used to kill the victim when the offender is characterized with sadism. Implications of the findings are discussed in light of our understanding of the crime-commission process involved in sexual homicide.     

The epidemiology of sexual assault of older female nursing home residents,in Victoria Australia,between 2000 and 2015

Sexual assault is the least acknowledged, detected, and reported type of assault against nursing home residents. Nursing home staff are responsible for reporting suspected allegations to the police, who will contact a clinical forensic examiner to conduct a forensic medical examination.This study examined the epidemiology of sexual assaults of older women (aged 65 years and older) residing in nursing homes in Victoria, Australia, between 2000 and 2015, whose alleged incidents were referred to a clinical forensic examiner for a forensic medical examination. A retrospective analysis of alleged sexual assaults reported to the Clinical Forensic Medicine Unit at the Victorian Institute of Forensic Medicine between 1 January 2000 and 31 December 2015 was conducted.The study identified 28 forensic medical examinations performed for alleged sexual assault. The alleged victims frequently had cognitive impairments; injuries were infrequent; and alleged victims were cooperative. The forensic medical examiner responded within 72 h of reporting; and frequently noted limitations to physical examinations of the alleged victim.The actual number of sexual assaults during this period may be masked by under-reporting and, lack of identification by nursing home staff.There are many unresolved issues including: incidence, levels of reporting, nature of investigations, responses required to assist the victim, and the interventions needed to prevent sexual assault. Better data is vital. This data should be standardized, validated, reliable, and gathered prospectively across Australia and internationally.     

A case of hunting death due to an overpenetrated bullet

The authors report the case of a death which occurred during wild boar hunting. The scene details revealed that the victim and the beast were aligned in the visual shooting path and the victim had been struck by overpenetrating bullet shot by his friend on the neighbouring stand. The fatal entrance wound was on the victim’s left chest. The authors emphasise the importance of the exhaustive forensic investigation, including autopsy of the beast, in cases like this, in order to distinguish accident from homicide.     

Forensic nursing – Global scenario and Indian perspective

Sexual violence is a significant cause of physical and psychological harm and suffering for women and children. Although sexual violence mostly affects women and girls, boys are also subject to child sexual abuse. Nurse is the person who attends the victim first. In order to meet the rigid and ever-changing demands of providing care to the victim and complying with our confusing system of laws, the nursing should has been forced to expand into a Forensic nursing, specialty of its own. Nursing roles in the criminal justice service known by many names worldwide-Custody nursing, Prison/Correctional nursing, Immigration centre nursing, Sexual Assault Nurse Examiner (SANE) or Sexual Assault Forensic Examiner (SAFE), SARTs (Sexual assault response team), SARCs (Sexual assault referral centre) and FNDIs (Forensic nurse death investigator). In India the premier institutes like AIIMS New Delhi and The PGI Chandigarh, do not have forensic content in their nursing curriculum manuals. The WHO and IAFN have urged inclusion of forensic content in both undergraduate and postgraduate nursing programs. Forensic Nurse Specialist can provide direct services to individual clients, consultation services to nursing, medical and law-related agencies, as well as providing expert court testimony in areas dealing with trauma and/or questioned death investigative processes, adequacy of services delivered, and specialized diagnoses of specific medical conditions. Research Findings on the Effectiveness of Sexual Assault Nurse Examiner (SANE) Programs suggests various improvements in each and every step in care of victim of sexual assault.     

Fatal intimate partner violence against women in Portugal: A forensic medical national study

Intimate partner violence (IPV) is an important cause of women's health and socio-familial severe problems, the most extreme being the victims' homicide. This is the first nationwide Portuguese autopsy-based and judicial-proven study about female intimate partner homicide.At least 62 women over 15 years old were killed by current or former men-intimate partners, corresponding to an IPV-related female mortality rate of 0.44/100.000 women; intimate partner violence was the reason of homicide in 60.8% of all autopsied women.The typical Portuguese victim showed to be a young adult woman, employed, killed by a current husband in a long-term relationship, usually with children in common and with a history of previous IPV. The typical Portuguese perpetrator showed to be older than the victim, employed, owning a firearm and without criminal records. At the time of the fatal event 59.7% of the relationships were current. In 57.9% of the former relationships women were killed during the 1st year after its terminus. Near half of the perpetrators attempted or committed suicide afterward. Most women were killed by gunshot wounds (45.2%), especially in the thorax (48.4%), with multiple fatal injuries; 56.5% also presented non-fatal injuries.The detection of prior IPV and the risk evaluation seems to be fundamental to decrease these fatal outcomes, but also, the prevention of perpetrators' alcohol abuse and carrying weapons. This work emphasizes the need to deepen the research on this issue, aiming to contribute to prevent both fatal and non-fatal IPV-related cases.     

Facilities for complainants of sexual assault throughout the United Kingdom

BACKGROUND: A sexual assault referral centre (SARC) is a model of service established to address the forensic and therapeutic needs arising following sexual assault. As yet, only a minority of urban areas in England are served by one, the rest of the United Kingdom (UK) being served by police victim examination suites. OBJECTIVE: To examine variations in service offered to complainants of sexual assault within the United Kingdom in 2005. METHODS: A purpose designed questionnaire sent to all areas of the United Kingdom. Data were received and analysed from 12 of 13 SARCs and 54 of 58 non SARC services. RESULTS: Very wide disparities in service, most marked between SARC and non SARC services. SARCs see a proportion of complainants from non-police sources. The non SARC services do not usually offer a forensic examination without police involvement, and a significant minority have so few doctors that they cannot provide a 24h rota for examinations. Inadequate numbers of forensic physicians are available for child examinations, and a robust service for 'acute child sexual assault' is virtually absent. Photodocumentation with appropriate safe storage is available in all SARCs, while 45% of non SARCs have no facility for photodocumentation. DNA contamination issues were perceived to be significant in many of non SARC services. Most non SARC services for adults do not provide baseline screening for sexually transmitted infection (STI) or offer prophylaxis against STIs. Follow up is by referral to local clinics which complainants may have to arrange themselves. Funded counselling is rare in the non SARCs with the exception of Yorkshire. CONCLUSION: In the non SARC services, lack of co-operative working with local health services, lack of equipment, and lack of 'in house' medical follow up arrangements is the norm. Many areas rely on the good will of a small number of doctors to provide a service without a rota.     

Condom-murder

Condom-murder is term used to describe a homicide where a person has been killed due to his recreational sexual behaviour and the killing has strong links with the recovered condom/contraceptive material on the scene or was in personal possession of victim. It can provide immediate clue about perpetrator. We present six cases of a similar nature. Four males and two females had condoms in their vicinity at crime scene. All incidents occurred at different timings and different places but there was striking similarity in method of killing. In four cases hands were tied on the back in three cases; similarly legs were also tied in three cases. In three cases strong electric cords were used. The presence of condoms give clue for investigation, possibility of DNA identification, about type of sexual behaviour as recreational and commercial method in these cases.     

Overkilling: A specific type of homicide – Constructing the definition: Perpetrator,weapon and circumstances

Overkilling in the Forensic Medicine is known as a specific type of homicide where the number of inflicted injuries greatly surpasses the number of fatal ones. Conducted research aimed to create a unified definition of the phenomenon and its classification criteria by analysing a vast majority of variables concerning its various characteristics. From the population of homicide victims autopsied in the authors’ research facility a number of 167 cases were chosen consisting of both overkilling and other homicides. 70 cases were thoroughly analysed based on the completed court files, autopsy protocols and photographs. Second part of the research concerned the facts regarding the perpetrator, used weapon and the circumstances of the act. Conclusions of the conducted analysis allowed to add further characteristics to the overkilling definition: the perpetrators were almost exclusively men, around 35 of age, not related to the victim but might have been in a close relationship with them, often a conflicted one. They did not threaten the victim before the incident. Mostly perpetrators were not intoxicated, and they tried to cover up the homicide in various ways. Perpetrators of overkilling were in most cases mentally disturbed (and thus stated insane), had different levels of intelligence but also a low level of planning before the act – rarely taking actions as preparing the weapon in advance, choosing the scene or luring in the victim.     

Comparative study of spermatozoa detection using the genital swab versus bedside smear slide technique in sexual assault patients

BackgroundSpecimen collection from sexual assault victims is an essential part of practice in forensic medicine. Semen analysis is a forensic test used to confirm sexual contact. Two methods of specimen collection were compared in this study: the genital swab and bedside slide smear.Materials and methodsA retrospective chart review was performed in the Division of Clinical Forensic Medicine, Siriraj Hospital, Thailand. Data were collected on microscopic spermatozoa detection in the external and internal genitalia, the time interval from assault to visit, and the history of condom use and genital cleansing. McNemar's test was used for comparison between the genital swab and bedside slide smear techniques.ResultsIn total, 724 case files from 2009 to 2013 were reviewed. The genital swab technique yielded a higher detection rate than did the bedside slide smear technique in both the external genitalia (37.0% vs. 31.8%, respectively) and internal genitalia (40.8% vs. 34.1%, respectively). Collection of a genital swab only missed positive cases in 4%–6% of negative swabs. When considering both the external and internal genitalia, the genital swab still yielded a higher rate of positive results than did the slide smear (45.9% vs. 39.0%, respectively). Examination of the victim within the first 3 days produced the highest spermatozoa detection rate (46.3%).ConclusionsThe genital swab is the preferred specimen collection method for spermatozoa detection in adult sexual assault victims. However, collection of both a swab and slide specimen may be considered in some cases. Collection of specimens later than 3 days after the assault greatly decreases the rate of spermatozoa detection.     

Suicide by drowning after two gunshots to the head: a case report

Differentiation between suicide and homicide can be problematic for forensic pathologists, especially when a complex method of suicide is used by the victim. Multiple gunshot suicides have been previously reported in the forensic literature. However, multiple gunshots combined with other suicidal methods are rare. In this article the authors report the unusual case of a floating body recovered from a river, with two gunshot wounds to the head. The autopsy showed that both gunshot wounds were nonlethal and the cause of death was attributed to drowning. Though homicide was strongly suspected at first, the manner of death was later established as suicide.     

Elder homicide in the north of Portugal

IntroductionThe increasing average life expectancy leads to population aging, and growing numbers in the elder population, a population that suffers from great vulnerability. Therefore, a rise in elder homicide is expected. This phenomenon has not been thoroughly described in Portugal. This study aims to analyse and characterize elder homicide, in order to achieve a better understanding of this form of violence.Material and MethodsWe conducted a retrospective study, reviewing autopsy reports along with data regarding circumstances of death of suspected homicides occurring between 1992 and 2007 (n = 78), whose victims were 65 years old or above, autopsied in the medical–legal services of the north of Portugal.ResultsDuring this period, an overall of 615 suspected homicides occurred, 13% being perpetrated against elders. The age range of the victims was 65–96 years, with an average of 74 years; 58% of them were males and 45% were married. In 61% of the documented cases, the perpetrator was known to the victim, and a family member in 36%. A considerable number of deaths occurred at the victim’s residence and in a rural scenario, the motive being robbery in 51% of the documented cases. The supposed perpetrator ran away from the scene in 64% of the cases. The most frequent mechanisms of death were blunt force trauma (31%), followed by stabbing (22%) and gunshot wounds (21%). Fatal wounds were observed mainly in the head (55%) and thorax (35%).ConclusionsIn the north of Portugal, elder homicide seems to be uncommon. This study suggests an association between elder homicide and robbery, in which elders, due to their vulnerability, are a preferential target. Contrary to other reports worldwide, there were no cases of death in nursing homes, possibly due to underreport or misidentification. In a large number of the cases, it wasn’t possible to collect all the necessary data, due to lack of information regarding circumstances of the events.     

An act of homicide and what it brings to mind: a case presentation

There are many views and studies as to the motive, manner, and victim of homicide, which is one of the severest forms of violence. The case presented here is that of a man who was strangled with a nylon ligature by his prison cellmate who later stabbed his victim's eyes with a piece of wood and a nail and slashed his face. The study is presented with respect to how the murder was committed and how the defendant was evaluated.     

Three-dimensional (3-D) imaging in post-mortem examinations: elucidation and identification of cranial and facial fractures in victims of homicide utilizing 3-D computerized imaging reconstruction techniques

The analysis of cranial and facial fractures in skeletal remains of homicidal victims can prove challenging for forensic anthropologists and forensic pathologists in postmortem examination. In such cases, the use of 3-D computerized imaging to elucidate the fractures and patterns of injuries can provide strong medical evidence that is very useful during litigation and at trial. The authors describe 3-D reconstructions of the skull performed as part of forensic postmortem examination in a recent victim of homicide. Received: 16 June 1998 / Received in revised form: 22 February 1999     

An unusual autopsy case of a victim stabbed during sadomasochistic prostitution

A 29-year-old male who lived alone was found dead with his back leaning against the wall of his room. He had been stabbed in his abdomen with a survival-type knife. The victim's mouth was plugged with a pink-colored glove and was sealed with packing tape. His wrists were tightly tied behind his back with the same type of packing tape. The cause of death was diagnosed as hemorrhage from the right common iliac artery and vein. Due to the strange circumstances of the crime scene, the police initially considered the possibility of homicide by a group of assassins. Two months later, the police arrested a male suspect who was a member of a vice racketeer. The victim was characterized as a masochist and bisexual. He often hired the male suspect to perform sadomasochistic activities. On the day of the crime, the victim prepared a survival-type knife and packing tape himself to experience fear and pain more strongly. The victim hoped to use the knife to increase sexual excitement. In this case of sadomasochistic prostitution leading to death, the legal issues of homicide for money, malicious request of injury by the victim and accidental death were involved.     

Evaluating the prevalence of DNA mixtures found in fingernail samples from victims and suspects in homicide cases

An important aspect of homicide investigations is the identification of the persons that had the last contact with the victim prior to death. Violent crimes are frequently characterized by a struggle between the victim and the perpetrator where biological material can be expected to be exchanged between them.Forensic DNA typing enables the generation of genetic profiles by extraction and amplification of cellular material found under fingernails. The evidential value of these samples may be critical if the secondary contributor found in a DNA mixture, can be matched with a potential suspect, or through a DNA database search.The amount of biological material transferred under the fingernails during “casual” activities is not sufficient to genotype reportable mixtures. This may not be the case with homicide victims that may have struggled and died under violent circumstances.The aim of this study was to evaluate the prevalence of DNA mixtures found under the fingernails of both victims and suspected perpetrators of violent deaths.We present a retrospective study of 137 DNA profiles genotyped from fingernail samples of homicide victims and suspects, collected at the Israeli National Center of Forensic Medicine. The majority of the samples produced single source profiles (n = 107, 78%) that matched those of the donor's. DNA mixtures (n = 30, 22%) were found in increased frequency among victims (n = 25/100, 25%) compared to suspects (n = 5/37, 13.5%). Mixtures were sub-divided into high level (n = 15, 50%), low level (n = 9, 30%) and residual (n = 6, 20%), according to the number of the foreign contributors’ alleles. Thus, this distinctive group of homicide victims was found to express both elevated frequency of DNA mixtures together with highly informative value of the secondary foreign profiles, as compared to other studied populations. These findings support an important aspect for the criminal investigation in murder cases, where a struggle may have ensued and the identification of an additional profile found in a mixture from a fingernail sample may point to a possible perpetrator of the crime.     

Suspected paradoxical undressing in a homicide case

Paradoxical undressing is a phenomenon associated with fatalities due to severe hypothermia, which is characterized by the act of active undressing, despite low ambient temperatures, as a consequence of peripheral vasodilation. A 51-year-old man was found lying naked and inanimate on a road. Articles of his clothing were scattered in surrounding bushes. A nearby handrail showed a partially washed away bloodstain pattern. A forensic autopsy was used to distinguish whether death was due to a hypothermic fatality or whether the deceased was a victim of an accident or homicide. Medicolegal autopsy revealed craniofacial dissociation with injuries to the thorax and extremities and established choking/asphyxia due to deep aspiration of blood in combination with external blood loss as the cause of death. In the absence of hypothermia-related signs and toxicological findings the case was considered to be a homicide. Police investigation led to the conviction of a man who confessed to having kicked and hit the victim and forced him to take off his clothes in a humiliation-related scenario.     

A systematic review of photogrammetry as a reliable methodology in gender identification of human skull

One of the most important parameters in the identification process in forensic Medicine and Dentistry is the determination of sex through the skull, based on morphological and metric dimorphism. Photogrammetry is an affordable option that allows the reconstruction of position, orientation, shape, and size, allowing the performance of quantitative and qualitative analyzes to identify the sex of the individual. However, there are few systematic reviews in the literature validating whether photogrammetry is a reliable methodology for sexual identification using human skulls. Therefore, the objective of the current systematic review was to validate whether photogrammetry of dry skulls is reliable as a method for calculating sex in human identification. This revision follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and was recorded in the Prospective International Systematic Reviews Registry (PROSPERO) (CRD420223 Systematic Registry) (CRD420223). The inclusion criteria for selecting the studies were based on the PICO question: “Is test photogrammetry reliable as a method for estimating sex in human identification?“. A literature search for studies was performed in the databases MEDLINE Scopus, Web of Science, LILACS, and the Cochrane Library. The Kappa agreement presented an approval level of (k = 0.93). This systematic review analyzed 11 ex-vivo studies published between 2001 and 2021. The risk of bias was considered low in 8 of the studies, and high in 3 studies. Based on this systematic review, it can be concluded that the photogrammetry method is viable and reliable in identifying sexual dimorphism.     

A young woman who killed 5 of her own babies: A case of multiple neonaticide

Neonaticide is a rare form of homicide. It is generally classed as manslaughter but differs from other forms of homicide in many respects. The factors favouring its occurrence and the legal position of neonaticide in Germany are discussed. The case is presented of a mother who committed five neonaticides within 8 years. While she was a caring mother for her two oldest children, she killed the five subsequent offspring immediately after giving birth. In the scarce literature on neonaticides, a case of multiple offending is particularly rare. Similarities to, and differences from, other cases of neonaticide in the literature are considered. The psychodynamic context of the offences is examined in order to identify contributing features which could be used to help prevent future occurrences.     

A medico-legal definition of femicide

Femicide refers to the extreme form of violence against someone belonging to the female gender, i.e. the killing of a woman. Research shows that, to date, gender-based violence remains largely a hidden phenomenon with prevalence often being underestimated by official statistics and data missing in numerous countries. It can be argued that the under-reporting may be suggestive of a legislative gap that needs addressing.This work aims to reach a shared medico-legal definition of femicide stemming from a comprehensive review of the current legislation of countries around the world. In addition, it appraises forensic pathology studies focusing on the murder of women as well as the most relevant documents published by prominent international organizations fighting violence against women. Review of the literature shows a scarcity of national legislations concerning specifically femicide, despite the attention given to this phenomenon by international organizations fighting violence against women.Additionally, a non-homogeneous framing of the term femicide arises from the forensic pathology literature and national laws. Starting from one of the funding principle of medical ethics – autonomy – authors propose to define femicide as a murder perpetrated because of a failure to recognize the victim’s right to self-determination.This definition would give the forensic pathologist a central role in identifying femicide cases among the murders of women. A shared forensic approach is needed, ideally employing standardized methodology to compare international data and to standardize scientific research in the field.